2020 Butler County Pennsylvania
Medicare Advantage Plans

There are 42 Medicare Advantage Plans available in Butler County PA from 7 different health insurance providers. 11 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $6700. Butler County Pennsylvania residents can also pick from 9 Medicare Special Needs Plans. The highest rated plan available in Butler County received a 4.5 overall star rating from CMS and the lowest rated plan is 3.5 stars



(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Plan
Rating
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AARP Medicare Advantage Plan 1 (HMO)
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$0 $0 $6,700 NoEnroll
AARP Medicare Advantage Plan 2 (HMO)
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$29.00 $0 $5,500 NoEnroll
AARP Medicare Advantage Plan 3 (HMO)
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$89.00 $0 $4,900 NoEnroll
Aetna Medicare Advantra Butler Prime (HMO)
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$0 $0 $6,700 YesEnroll
Aetna Medicare Advantra Credit Value (PPO)
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$0 $250.00 $6,700 YesEnroll
Aetna Medicare Advantra Gold (HMO)
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$58.00 $0 $4,900 YesEnroll
Aetna Medicare Advantra Silver (HMO)
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$0 $0 $6,700 YesEnroll
Aetna Medicare Advantra Silver (PPO)
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$28.00 $0 $6,700 YesEnroll
Aetna Medicare Gold Plan (PPO)
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$146.00 $0 $6,700 YesEnroll
Aetna Medicare Silver (HMO)
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$59.00 $0 $6,700 YesEnroll
Aetna Medicare Value (PPO)
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$0 $0 $6,700 YesEnroll
Allwell Medicare (HMO)
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$0 $0 $6,700 NoNAEnroll
Community Blue Medicare HMO Prestige (HMO)
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$246.00 $0 $6,700 YesEnroll
Community Blue Medicare HMO Signature (HMO)
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$0 $0 $6,700 NoEnroll
Community Blue Medicare PPO Distinct (PPO)
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$35.00 $0 $5,900 NoEnroll
Freedom Blue PPO Classic (PPO)
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$292.00 $0 $4,500 YesEnroll
Freedom Blue PPO Select (PPO)
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$171.00 $0 $5,000 NoEnroll
Freedom Blue PPO ValueRx (PPO)
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$76.00 $0 $5,500 NoEnroll
Humana Gold Plus H6622-054 (HMO)
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$0 $0 $6,700 NoEnroll
Humana Value Plus H5216-117 (PPO)
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$22.50 $435.00 $6,700 NoEnroll
HumanaChoice H5216-119 (PPO)
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$122.00 $0 $6,700 NoEnroll
HumanaChoice H5525-017 (PPO)
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$15.00 $0 $4,900 NoEnroll
HumanaChoice H5525-038 (PPO)
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$0 $0 $6,700 NoEnroll
HumanaChoice R0923-002 (Regional PPO)
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$71.00 $0 $6,700 NoEnroll
Security Blue HMO-POS Deluxe (HMO-POS)
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$267.50 $0 $4,500 YesEnroll
Security Blue HMO-POS Standard (HMO-POS)
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$200.50 $0 $5,000 NoEnroll
Security Blue HMO-POS ValueRx (HMO-POS)
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$64.00 $0 $5,500 NoEnroll
UPMC for Life HMO Deductible with Rx (HMO)
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$22.00 $0 $4,000 NoEnroll
UPMC for Life HMO Premier Rx (HMO)
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$0 $0 $6,000 NoEnroll
UPMC for Life HMO Rx (HMO)
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$81.00 $0 $3,400 NoEnroll
UPMC for Life HMO Rx Choice (HMO)
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$40.00 $0 $4,250 NoEnroll
UPMC for Life HMO Rx Enhanced (HMO)
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$301.00 $0 $3,400 NoEnroll
UPMC for Life PPO High Deductible with Rx (PPO)
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$35.00 $0 $6,700 NoEnroll
UPMC for Life PPO Rx Enhanced (PPO)
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$135.00 $0 $6,700 NoEnroll


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Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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AARP Medicare Advantage Essential (HMO)
$0 Local HMO * $5,500
Aetna Medicare Advantra Core (HMO)
$0 Local HMO * $4,900 Enroll
Humana Honor (PPO)
$0 Local PPO * $6,700
HumanaChoice H5216-116 (PPO)
$0 Local PPO * $3,900 Enroll
HumanaChoice R0923-001 (Regional PPO)
$0 Regional PPO * $4,900 Enroll
Lasso Healthcare (MSA)
MSA * $- NA
Security Blue HMO-POS Basic (HMO-POS)
$55.00 Local HMO * $5,900
UPMC for Life HMO No Rx (HMO)
$0 Local HMO * $3,400





2020 Medicare Special Needs Plans in Butler county Pennsylvania

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Aetna Medicare Advantra Cares (HMO D-SNP)     $20.40 $200.0  No Dual-Eligible
Allwell Dual Medicare (HMO D-SNP)     $34.00 $435.0  No Dual-EligibleNA
AmeriHealth Caritas VIP Care (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible
Gateway Health Medicare Assured Diamond (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible
Gateway Health Medicare Assured Ruby (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP)     $35.60 $435.0  No InstitutionalNA
UnitedHealthcare Dual Complete (HMO D-SNP)     $22.90 $435.0  No Dual-Eligible
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)     $35.40 $435.0  No Institutional
UPMC for Life Dual (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible



Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type
  • (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of generic formulary products with coverage above standard generic coverage gap cost-sharing benefit and/or the percentage of brand formulary products covered in addition to the coverage gap discount for applicable drugs.
  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard

GAP

In 2020 once you and your plan provider have spent $4020 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will pay 25% of the plans cost for covered brand-name prescription drugs and 25% on generic drugs unless your plan offers additional coverage.

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable



Source: CMS. Data as of September 3, 2019.
Star Rating as of October 11, 2019.
For More Information on Ratings Please See the CMS Tech Notes.
Plans are subject to change as contracts are finalized.
Includes 2020 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2020, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.


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